As with most engineering/planning professions, part of my job is to build into my project the capability to accommodate moderate, somewhat forseen changes. In software, this requires designing data structures and logic flows in such a way that they can be easily modified to fulfill future requirements.
For many EMR product vendors, meeting meaningful use guidelines is their requirement. For my client, improved safety and efficiency are the main requirements. Whose requirements are more likely to change? The requirements ”standardized’ by the government? (a entity designed to be in constant flux) or the requirements of the compounded expertise of doctors, nurses and administrative experts in the field?
As a programmer, I always assume that requirements will change to some degree and I am sure that these meaningful use guidelines are no different. As with nearly everyone else, I think that the guidelines won’t be met to any significant degree this year, or probably by 2014. Will the guidelines stand and roll on to the penalties in 2015 or will lawmakers listen expert advice and change the guidelines?
Let’s be optimistic. Let’s say they listen to the experts. What are the meaningful use guidelines 6 or 9 months from now? How can lawmakers describe their intent to us without dictating crippling specifics that might not even be relevant with furture technologies? How can we infer ‘Desired Functionality‘ from these ‘Meaningful Use‘ guidelines? If we can do that, maybe we can make good guesses about what future specifc requirements might be.
Cynics will say that all of this hubub is so the government can dictate your practice. A believer would tell you that the government wants to humbly ask for some patient data (and a glass of milk) so that it can make people safer. I think both the cynic and the believer are right, because they both describe a situation where the government wants your information. And they don’t want just YOUR information, but the information of with whom you consult, what drugs you use, whether they should fire one of your employees for a mis-treatment, the list goes on.
So let’s rename “Meaningful Use ” guidelines to “Information reporting ” requirements. Maybe with this mindset we can stay out of the quagmire of the specifics of meaningful use, but leave the door open for the inevitable reporting requirements down the road.